Individual provider Active NPI

Robert Kalugo

  • Psychiatric/Mental Health Nurse Practitioner
  • Devens, MA
National Provider Identifier
1730878273
Registry record updated May 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN2313384 Issued in MA
Practice address
85 Patton Rd
Devens, MA 01434-4401
Phone
(978) 615-5200
NPI assigned
May 2, 2023
Last updated
May 2, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN2313384 MA Primary

Addresses

Primary practice location

85 Patton Rd
Devens, MA 01434-4401

Mailing address

85 Patton Rd
Devens, MA 01434-4401

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240430000056 MA Practitioner - Nurse Practitioner 1355781006 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

85 Patton Rd
Devens, MA 01434-4401
Phone (978) 615-5200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN2313384MAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Devens Treatment & Recovery Center, LLC Single Specialty CurrentSince Feb 21, 2024 Accepting new patients
Devens Treatment & Recovery Center, LLC Past Accepting new patients

Locations

19 Midstate Dr
Ste 110
Auburn, MA 01501

85 Patton Rd
Devens, MA 01434
Phone (978) 615-5200

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1682985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682985600000",
    "number": "1730878273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 PATTON RD",
            "city": "DEVENS",
            "state": "MA",
            "postal_code": "014344401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 PATTON RD",
            "city": "DEVENS",
            "state": "MA",
            "postal_code": "014344401",
            "telephone_number": "978-615-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALUGO",
        "first_name": "ROBERT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-02",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2313384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Devens, MA

Sources for this page

Verify at the official NPI Registry.